缺血性脑血管病认知功能损害及精神心理异常的分析研究  

Analysis of cognitive impairment and mental disorder in ischemic cerebrovascular disease

作　　者：戴培 于惠贤 王赵霞 刘长彬 刘思豪 徐光青 DAI Pei;YU Huixian;WANG Zhaoxia(Beijing Tiantan Hospital,Capital Medical University,Beijing,100070)

机构地区：[1]首都医科大学附属北京天坛医院康复医学,北京市100070 [2]广东省人民医院康复医学科

出　　处：《中国康复医学杂志》2023年第6期756-760,共5页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金项目(82072548)。

摘　　要：目的:探讨缺血性脑血管病患者中单纯脑小血管病(CSVD)与伴CSVD表现的大动脉粥样硬化(LAA)型脑梗死患者认知功能损害及精神心理异常的特点及差异。方法:选取符合入组标准的单纯CSVD患者14例,与伴CSVD表现的LAA型脑梗死患者28例,观察两组在CSVD总负担评分、Fazekas评分、MoCA评分、Stroop色词测验及连线测验、汉密尔顿抑郁评分方面的异同。同时进一步将伴CSVD表现的LAA型脑梗死分为前后循环组与单纯CSVD组进行比较,观察认知功能损害情况。结果:伴CSVD的LAA型脑梗死与单纯CSVD患者比较,后者CSVD总负担评分及Fazekas评分更高,Stroop C用时更长,抑郁评分更高,差异均有显著性(P<0.05)。伴CSVD的LAA型后循环脑梗死患者MoCA量表子项定向力评分明显高于单纯CSVD患者。结论:单纯CSVD患者与伴CSVD的LAA型脑梗死患者相比,所有认知域中执行功能损害更为明显,且抑郁评分更高。伴CSVD的后循环梗死患者定向力要好于单纯CSVD患者。Objective:To investigate the characteristics and differences of cognitive impairment and mental disorder in patients with cerebral small vessel disease(CSVD)and large artery atherosclerosis(LAA)cerebral infarction with CSVD manifestation.Method:A total of 14 patients with CSVD and 28 patients with LAA cerebral infarction with CSVD manifestation were selected.The total CSVD score,Fazekas score,MoCA score,stroop color-word test(SCWT),trail marking test(TMT)and Hamilton depression score were observed for the two groups.At the same time,LAA cerebral infarction with CSVD manifestation was further divided into anterior and posterior circulation group,to comparing the cognitive impairment with CSVD group.Result:LAA cerebral infarction with CSVD manifestation had higher total CSVD score and Fazekas score,longer complete time of Stroop C,and higher depression score than patients with CSVD alone(P<0.05).The subitem orientation score of MoCA in LAA-posterior circulation cerebral infarction patients with CSVD manifestation was significantly higher than that in patients with CSVD.Conclusion:Compared with LAA cerebral infarction patients with CSVD manifestation,patients with CSVD have more obvious impairment of executive function in all cognitive domains and higher depression scores.Patients with posterior circulation infarction with CSVD manifestation had better orientation ability than patients with CSVD alone.

关 键 词：脑小血管病 大动脉粥样硬化型脑梗死 认知障碍 卒中后抑郁 执行功能 

分 类 号：R743[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学] R749.4